Fuchs综合征16例临床误诊分析

Clinical Misdiagnosis 16 Cases of Fuchs Syndrome

目的 探讨Fuchs综合征误诊原因,提高诊疗水平。方法 回顾性分析我院收治的误诊为其他疾病的16例Fuchs综合征的临床资料。结果 16例因视力下降、眼部红痛等症状就诊,均误诊,误诊时间5d^15个月,误诊为青光眼睫状体炎综合征6例,中间葡萄膜炎3例,特发性慢性前葡萄膜炎、年龄相关性白内障、原发性开角型青光眼各2例,前葡萄膜炎1例,予相应治疗症状均未好转。后完善裂隙灯、眼压、视野等相关检查,确诊为Fuchs综合征,其中2例并发白内障患者予超声乳化吸除联合人工晶体植入术,术后视力提高;1例眼压偏高药物控制欠佳者予Ex-PRESS引流钉植入术,术后眼压控制可;13例予局部非甾体类抗炎、药物降眼压等对症治疗,病情得以控制。结论 掌握Fuchs综合征的虹膜脱色素、特征性角膜后沉着物等特征性改变,有助于减少误诊误治。

Objective To explore the causes of misdiagnosis of Fuchs syndrome, so as to improve diagnosis and treatment. Methods Clinical data of 16 cases of Fuchs syndrome misdiagnosed as other diseases in our hospital were retrospectively analyzed. Results Sixteen patients presented with various symptoms, including decreased vision and painful red eye. They were all misdiagnosed, and the duration of misdiagnosis was 5 days to 15 months. The misdiagnosed diseases included posner-schlossman syndrome in 6 cases,intermediate uveitis in 3 cases, idiopathic chronic pre-uveitis in 2 cases, age-related cataract in 2 cases, primary open-angle glaucoma in 2 cases, and anterior uveitis in 1 case. Symptoms were not improved after the corresponding treatment. After the performing relevant examinations, such as slit lamps, intraocular pressure (IOP), and field of vision, they were diagnosed as Fuchs syndrome. Of them, two patients with complicated cataract underwent phacoemulsification combined with intraocular lens implantation, and their vision was improved after surgery. One case having poor drug control over high IOP was implanted with Ex-PRESS glaucoma drainage nail, and postoperative IOP was well controlled. Thirteen cases were given symptomatic treatment, including local non-steroidal anti-inflammatory drugs and drugs to lower IOP, and the condition was controlled. Conclusion Mastering the characteristic changes such as iris depigmentation and characteristic keratic precipitates in Fuchs syndrome can help reduce misdiagnosis and mistreatment.